Hydrocortisone for Acne: Does It Work? Dermatologists Explain

When it comes to acne treatments, we've heard it all. From aspirin to toothpaste and everything in between, it would seem that everyone on the internet has their own hack for eradicating pimples. So we were a little skeptical when we heard about the blemish-busting powers of hydrocortisone cream. You're probably familiar with a tube of the anti-inflammatory stuff tucked in your parents' medicine cabinet. (Maybe you even had a mom or grandmother who evangelized its ability, in the form of Prep H, to reduce under-eye bags.) But acne? Really?

As it turns out, there's actually some truth in using this unsuspecting ingredient as a fast and effective spot treatment. Ahead, dermatologists Joshua Zeichner and Jordan Carqueville, explain why hydrocortisone works and exactly how you should use it.

What Is Hydrocortisone?

"Hydrocortisone is a corticosteroid, a medicine that reduces inflammation," explains Dr. Zeichner. It's a common anti-inflammatory treatment for skin conditions such as eczema or psoriasis, adds Dr. Carqueville, and is available both over-the-counter and as a prescription. (A one-percent concentration is the maximum strength available without a prescription). And to the over-the-counter point, it's often a go-to treatment for itchy, irritated, skin problems; think bug bites, rashes, poison ivy, and the like.

On the acne front, you may have heard of dermatologists using cortisone injections to quickly calm large, angry pimples. While both cortisone and hydrocortisone belong to the same family of corticosteroids, cortisone has to be converted to hydrocortisone in the liver, and won't work topically (hence the injection part). Still, over-the-counter hydrocortisone may offer a similar benefit to the injectable cortisone, says Dr. Zeichner.

Is Hydrocortisone Suitable for Acne Treatment?

It's important to first point out that because hydrocortisone works by combating inflammation, "it's not meant for blackheads or whiteheads, but rather for red, angry, underground pimples," says Dr. Carqueville. It's also not something you should be using across your entire face; instead, it's best for super-targeted spots and used for only short amounts of time (more on both points in a moment). However, it definitely is effective at soothing inflammation. It works particularly well when paired with not only benzoyl peroxide, but also salicylic acid, sulfur, and retinoids: "These ingredients work together to reduce the causes of an inflamed pimple—the oil at the skin surface, the clogging of the pore, and the acne-causing bacteria P. acnes," explains Dr. Carqueville. However, it's worth noting that when choosing over-the-counter hydrocortisone for blemish-busting purposes, it's important to seek out a cream formula rather than an ointment. The occlusive texture of an ointment can be inherently pore-clogging, says Dr. Carqueville.

Benefits of Hydrocortisone for Acne Treatment

Hydrocortisone can offer some aesthetic aid in terms of acne and blemishes in the following ways:

• Reducing inflammation and swelling at the site
• Counteracting redness
• Minimizing irritation

Potential Side Effects

So why should hydrocortisone use be limited? "Overuse of topical steroids can lead to thinning and discoloration of the skin," cautions Dr. Carqueville. She advises using hydrocortisone on a blemish no more than twice daily, for two days max. Dr. Zeichner also warns about the overuse of topical steroids (though says you can use hydrocortisone on a blemish for up to two weeks). In an ironic twist, another possible side effect can be even more pimples: "Steroid acne is a well-described phenomenon where continuous use of topical steroids causes acne," says Dr. Zeichner. Overuse can also lead to steroid-induced dermatitis, perioral dermatitis specifically, which manifests as a red, bumpy rash around your nose and mouth, adds Dr. Carqueville. No, thank you.

How to Apply Hydrocortisone on Acne

As mentioned, it's going to work best when paired with other ingredients. Try Dr. Zeichner's homemade spot treatment and combine a one-percent over-the-counter hydrocortisone cream plus a product containing two percent salicylic acid plus a product containing two-and-a-half percent benzoyl peroxide (use equal parts of each). Dab this concoction directly onto the pimple. Not a fan of whipping up skincare in your kitchen? Try Aveeno's Active Naturals 1% Hydrocortisone Anti-Itch Cream ($8) which, along with hydrocortisone, also boasts a triple oat complex. Colloidal oats are a choice skin soother to help further reduce inflammation, says Dr. Zeichner.

Another option: Dr. Carqueville suggests first washing your face with a sulfur-based cleanser, then layering the hydrocortisone under a five-percent benzoyl peroxide product in the morning. Repeat this in the evening, swapping the benzoyl peroxide product for one with either a two-percent salicylic acid product or an over-the-counter retinoid. In either scenario, this is meant to be a short-term, quick fix, and not a regular part of your skincare routine.

The Takeaway

If used deliberately—and sparingly—as an acne spot treatment, hydrocortisone can provide a temporary fix to the appearance of an angry pimple. While its benefits provide a quick solution to the more visual ailments of redness and swelling that come with acne, it won't provide any long-term cure to the actual cause of the blemishes. Seeing a pimple seemingly go away can be gratifying in the moment, but becoming dependent on hydrocortisone as a spot treatment can lead to more skin irritation as a result of overuse.